Improving osteoarthritis detection in the community: Pharmacist identification of new, diagnostically confirmed osteoarthritis
Abstract
Objective: Osteoarthritis (OA) is the most common arthritis and a leading cause of disability. Many persons with knee OA are not diagnosed and not referred for treatment. Therefore, identification of patients with knee pain who have undiagnosed OA needs to be improved. Our objective was to determine if pharmacists, using a simple screening questionnaire, can identify individuals with previously undiagnosed knee OA. Methods: Patients with knee pain and no previous diagnosis of knee OA were recruited by community pharmacists who used a simple questionnaire (<10 minutes to complete) to determine likelihood of knee OA. Patients who were likely to have knee OA were referred for a standardized knee examination and radiograph. Results: Of the 411 patients screened by pharmacists, 274 were eligible. Of these, 44 declined, 35 were ineligible (18 had a previous OA diagnosis,16 had other inflammatory conditions, and 1 was excluded for other reasons), and 1 died. The remaining 194 were mostly female (62%) with a mean age of 62 years and were mostly white (86%). Body mass index (BMI) was classified as normal (18.5–24.9 kg/m 2) in 29%, overweight (25.0–29.9 kg/m 2) in 45%, and obese (>30.0 kg/m 2) in 26%. Of those examined, 190 (98%) of 194 met the American College of Rheumatology clinical criteria for knee OA. The radiographic results revealed that most participants likely had mild OA. Conclusion: Pharmacists administering a simple screening questionnaire can identify >80% of patients with knee pain who have undiagnosed knee OA. Based on radiographs and BMI, much of this OA is early and may be amenable to intervention.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In a community-based study by Marra et al, 191 of 195 (98.0%) urban-dwelling participants who met the early osteoarthritis criteria also met the American College of Rheumatology clinical criteria for knee osteoarthritis.
“In a community-based study by Marra et al [27], 191 of 195 (98.0%) urban-dwelling participants who met these criteria also met the American College of Rheumatology clinical criteria for knee OA [28].”
From A Community-Based Physical Activity Counselling Program for People With Knee Osteoarthritis: Feasibility and Preliminary Efficacy of the Track-OA Study (2017) · cites this paper as [27]
Cites
Intraclass correlations: Uses in assessing rater reliability.
Shrout, P. E., & Fleiss, J. L. (1979) · Psychological Bulletin · doi:10.1037/0033-2909.86.2.420 · Cited by 23,433 · see citing works
Radiological Assessment of Osteo-Arthrosis
Kellgren, J., & Lawrence, J. S. (1957) · Annals of the Rheumatic Diseases · doi:10.1136/ard.16.4.494 · Cited by 12,472 · see citing works
Altman, R., Asch, E., Bloch, D., Bole, G., Borenstein, D., Brandt, K., Christy, W., Cooke, T. D., Greenwald, R., Hochberg, M., et al. (1986) · Arthritis & Rheumatism · doi:10.1002/art.1780290816 · Cited by 6,777 · see citing works
Peat, G., McCarney, R., & Croft, P. (2001) · Annals of the Rheumatic Diseases · doi:10.1136/ard.60.2.91 · Cited by 1,338 · see citing works
Christensen, R., Bartels, E. M., Astrup, A. V., & Bliddal, H. (2007) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2006.065904 · Cited by 632 · see citing works
Bellamy, N. (2002) · PubMed · Cited by 289 · see citing works
Tsuyuki, R. T. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.10.1149 · Cited by 289 · see citing works
Self-citationRothman, R. L., Malone, R., Shilliday, B. B., Shintani, A., Crigler, B., DeWalt, D. A., Dittus, R. S., Weinberger, M., & Pignone, M. P. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2004.09.017 · Cited by 266 · see citing works
Miller, G. D., Nicklas, B. J., Davis, C., Loeser, R. F., Lenchik, L., & Messier, S. P. (2006) · Obesity · doi:10.1038/oby.2006.139 · Cited by 247 · see citing works
Reliability of the knee examination in osteoarthritis: Effect of standardization
Cibere, J., Bellamy, N., Thorne, A., Esdaile, J. M., McGorm, K. J., Chalmers, A., Huang, S., Peloso, P. M. J., Shojania, K., Singer, J., et al. (2004) · Arthritis & Rheumatism · doi:10.1002/art.20025 · Cited by 204 · see citing works
Self-citationKosinski, M. R., Keller, S., Ware, J. E., Hatoum, H. T., & Kong, S. X. (1999) · Medical Care · doi:10.1097/00005650-199905001-00003 · Cited by 190 · see citing works
Focht, B. C., Rejeski, W. J., Ambrosius, W. T., Katula, J. A., & Messier, S. P. (2005) · Arthritis Care & Research · doi:10.1002/art.21466 · Cited by 175 · see citing works
Hay, E. M., Foster, N. E., Thomas, E., Peat, G., Phelan, M., Yates, H., Blenkinsopp, A., & Sim, J. (2006) · BMJ · doi:10.1136/bmj.38977.590752.0b · Cited by 168 · see citing works
Hypertension outcomes through blood pressure monitoring and evaluation by pharmacists (HOME study)
Zillich, A. J., Sutherland, J. M., Kumbera, P. A., & Carter, B. L. (2005) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2005.0226.x · Cited by 142 · see citing works
Availability of Primary Care Providers and Pharmacists in the United States
Knapp, K. K., Paavola, F. G., Maine, L. L., Sorofman, B. A., & Politzer, R. M. (1999) · Journal of the American Pharmaceutical Association (1996) · doi:10.1016/s1086-5802(16)30486-7 · Cited by 111 · see citing works
Quality of osteoarthritis care for community‐dwelling older adults
Ganz, D. A., Chang, J. T., Roth, C. P., Guan, M., KAMBERG, C. J., Niu, F., Reuben, D. B., Shekelle, P., Wenger, N. S., & MacLean, C. H. (2006) · Arthritis Care & Research · doi:10.1002/art.21844 · Cited by 97 · see citing works
Leal, S., Glover, J. J., Herrier, R. N., & Felix, A. (2004) · Diabetes Care · doi:10.2337/diacare.27.12.2983 · Cited by 86 · see citing works
Mazzuca, S. A., Page, M. C., Meldrum, R. D., Brandt, K. D., & Petty-Saphon, S. (2004) · Arthritis Care & Research · doi:10.1002/art.20683 · Cited by 72 · see citing works
Leung, W. Y. S., So, W., Tong, P. C. Y., Chan, N. N., & Chan, J. C. N. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.07.050 · Cited by 66 · see citing works
Tsuyuki, R. T., Olson, K. L., Dubyk, A., Schindel, T., & Johnson, J. A. (2004) · The American Journal of Medicine · doi:10.1016/j.amjmed.2003.09.024 · Cited by 63 · see citing works
Self-citationLessons learned from nine clinical trials of disease‐modifying osteoarthritis drugs
Brandt, K. D., & Mazzuca, S. A. (2005) · Arthritis & Rheumatism · doi:10.1002/art.21409 · Cited by 58 · see citing works
The prevalence and impact of arthritis in older persons
Hughes, S. L., & Dunlop, D. D. (1995) · Arthritis & Rheumatism · doi:10.1002/art.1790080409 · Cited by 55 · see citing works
Glazier, R. H., Badley, E. M., Wright, J. G., Coyte, P. C., Williams, J., Harvey, B. J., Wilkins, A. L., & HAWKER, G. A. (2003) · PubMed · Cited by 39 · see citing works
Martin, K. L., Fontaine, K. R., Nicklas, B. J., Dennis, K. E., Goldberg, A. P., & Hochberg, M. (2001) · JCR Journal of Clinical Rheumatology · doi:10.1097/00124743-200108000-00006 · Cited by 36 · see citing works
Drug-Related Problems and Quality of Life in Arthritis and Low Back Pain Sufferers
Ernst, M. E., Iyer, S. S., & Doucette, W. R. (2003) · Value in Health · doi:10.1046/j.1524-4733.2003.00202.x · Cited by 36 · see citing works
Law, A. V., & Shapiro, K. (2005) · Journal of Evaluation in Clinical Practice · doi:10.1111/j.1365-2753.2005.00531.x · Cited by 34 · see citing works
Flagged first, then by citations
1 of the 27 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Holla, J., van der Leeden, M., Heymans, M. W., Roorda, L. D., Bierma‐Zeinstra, S., Boers, M., Lems, W. F., Steultjens, M. P. M., & Dekker, J. (2013) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2012-202984 · Cited by 102 · see citing works
Screening for major diseases in community pharmacies: a systematic review†
Ayorinde, A., Porteous, T., & Sharma, P. (2013) · International Journal of Pharmacy Practice · doi:10.1111/ijpp.12041 · Cited by 80 · see citing works
Quality of Nonpharmacological Care in the Community for People with Knee and Hip Osteoarthritis
LI, L. C., Sayre, E. C., Kopec, J. A., Esdaile, J. M., Bar, S., & Cibere, J. (2011) · The Journal of Rheumatology · doi:10.3899/jrheum.110264 · Cited by 76 · see citing works
Self-citationLi, L. C., Sayre, E. C., Xie, H., Clayton, C., & Feehan, L. M. (2017) · JMIR mHealth and uHealth · doi:10.2196/mhealth.7863 · Cited by 74 · see citing works
Granados, Y., Cedeño, L., Rosillo, C., Berbin, S., Azocar, M., Molina, M. E., Lara, O., Sánchez, G., & Peláez-Ballestas, I. D. P. (2014) · Clinical Rheumatology · doi:10.1007/s10067-014-2689-9 · Cited by 72 · see citing works
Epidemiology and costs associated with genital warts in Canada
Marra, F., Ogilvie, G. S., Colley, L., Kliewer, E. V., & Marra, C. A. (2008) · Sexually Transmitted Infections · doi:10.1136/sti.2008.030999 · Cited by 68 · see citing works
Self-citationHolla, J., Steultjens, M. P. M., Roorda, L. D., Heymans, M. W., ten Wolde, S., & Dekker, J. (2010) · Arthritis Care & Research · doi:10.1002/acr.20263 · Cited by 64 · see citing works
Marra, C. A., Cibere, J., Grubisić, M., Grindrod, K., Gastonguay, L., Thomas, J. M., Embley, P., Colley, L., Tsuyuki, R. T., Khan, K. M., et al. (2012) · Arthritis Care & Research · doi:10.1002/acr.21763 · Cited by 64 · see citing works
Self-citationChanging pharmacy practice: The leadership challenge
Tsuyuki, R. T., & Schindel, T. J. (2008) · Canadian Pharmacists Journal / Revue des Pharmaciens du Canada · doi:10.3821/1913-701x(2008)141[174:cpptlc]2.0.co;2 · Cited by 64 · see citing works
Self-citationLI, L. C., Sayre, E. C., Xie, H., Falck, R. S., Best, J. R., Liu-Ambrose, T. Y. L., Grewal, N., Hoens, A. M., Noonan, G., & Feehan, L. M. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.8514 · Cited by 63 · see citing works
Cibere, J., Zhang, H., Thorne, A., Wong, H., Singer, J., Kopec, J. A., Guermazi, A., PETERFY, C. G., Nicolaou, S., Munk, P. L., et al. (2010) · Arthritis Care & Research · doi:10.1002/acr.20314 · Cited by 62 · see citing works
Self-citationPinto, D., Robertson, M. C., Abbott, J. H., Hansen, P., & Campbell, A. J. (2013) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2013.06.014 · Cited by 62 · see citing works
Validity of the COPCORD Core Questionnaire as a Classification Tool for Rheumatic Diseases
Goycochea-Robles, M. V., Sanı́n, L. H., Moreno‐Montoya, J., Álvarez-Nemegyei, J., Burgos‐Vargas, R., Garza‐Elizondo, M. A., Rodríguez-Amado, J., MADARIAGA, M. A., ZAMUDIO, J. A., Cuervo, G. E., et al. (2011) · Journal of Rheumatology Supplement · doi:10.3899/jrheum.100955 · Cited by 45 · see citing works
An evidence‐informed, integrated framework for rheumatoid arthritis care
LI, L. C., Badley, E. M., MacKay, C., Mosher, D. P., Jamal, S., Jones, A., & Bombardier, C. (2008) · Arthritis Care & Research · doi:10.1002/art.23931 · Cited by 37 · see citing works
After patients are diagnosed with knee osteoarthritis, what do they do?
Grindrod, K., Marra, C. A., Colley, L., Cibere, J., Tsuyuki, R. T., Esdaile, J. M., Gastonguay, L., & Kopec, J. A. (2010) · Arthritis Care & Research · doi:10.1002/acr.20170 · Cited by 32 · see citing works
Self-citationFalck, R. S., Best, J. R., LI, L. C., Chan, P., Feehan, L. M., & Liu-Ambrose, T. Y. L. (2018) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-018-2369-z · Cited by 27 · see citing works
Falck, R. S., Hsu, C. L., Best, J. R., LI, L. C., Egbert, A. R., & Liu-Ambrose, T. Y. L. (2020) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002374 · Cited by 25 · see citing works
Marra, C. A., Grubisić, M., Cibere, J., Grindrod, K., Woolcott, J. C., Gastonguay, L., & Esdaile, J. M. (2013) · Arthritis Care & Research · doi:10.1002/acr.22232 · Cited by 25 · see citing works
Self-citationPractice guidelines for pharmacists: The management of osteoarthritis
Kielly, J., Davis, E., & Marra, C. A. (2017) · Canadian Pharmacists Journal / Revue des Pharmaciens du Canada · doi:10.1177/1715163517702168 · Cited by 23 · see citing works
Self-citationClinical validation of an Internet-based questionnaire for ascertaining hip and knee osteoarthritis
Ratzlaff, C., Koehoorn, M. W., Cibere, J., & Kopec, J. A. (2012) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2012.08.017 · Cited by 22 · see citing works
Self-citationLeese, J., Macdonald, G., Backman, C. L., Townsend, A. F., Nimmon, L., & LI, L. C. (2021) · JMIR mhealth and uhealth · doi:10.2196/30332 · Cited by 17 · see citing works
de Vera, M., Sadatsafavi, M., Tsao, N., Lynd, L., Lester, R., Gastonguay, L., Galo, J., Fitzgerald, J., Brasher, P., & Marra, C. (2014) · Trials · doi:10.1186/1745-6215-15-488 · Cited by 16 · see citing works
Self-citationClayton, C., Feehan, L. M., Goldsmith, C. H., Miller, W. C., Grewal, N., Ye, J., Yoo, J. Y., & LI, L. C. (2015) · Pilot and Feasibility Studies · doi:10.1186/s40814-015-0027-x · Cited by 15 · see citing works
Goto, H., Fujii, M., Iwama, Y., Aoyama, N., Ohno, Y., & Sugimura, K. (2012) · Journal of Medical Imaging and Radiation Oncology · doi:10.1111/j.1754-9485.2012.02388.x · Cited by 15 · see citing works
Vera, M. A. D., Campbell, N., Chhina, H., Galo, J. S., & Marra, C. A. (2017) · International Journal of Pharmacy Practice · doi:10.1111/ijpp.12409 · Cited by 13 · see citing works
Self-citationTwenty‐Four Hour Activity and Sleep Profiles for Adults Living with Arthritis: Habits Matter
Feehan, L. M., Lu, N., Xie, H. W., & LI, L. C. (2020) · Arthritis Care & Research · doi:10.1002/acr.24424 · Cited by 10 · see citing works
LI, L. C., Lineker, S. C., Cibere, J., Crooks, V. A., Jones, C. A., Kopec, J. A., Lear, S. A., Pencharz, J. N., Rhodes, R. E., & Esdaile, J. M. (2013) · JMIR Research Protocols · doi:10.2196/resprot.2553 · Cited by 11 · see citing works
Self-citationMcLachlan, A. J., Carroll, P. R., Hunter, D. J., Wakefield, T. A. N., & Stosic, R. (2022) · Health Expectations · doi:10.1111/hex.13429 · Cited by 10 · see citing works
The potential role of pharmacists in chronic disease screening
George, J., & Zairina, E. (2016) · International Journal of Pharmacy Practice · doi:10.1111/ijpp.12246 · Cited by 9 · see citing works
Clark, J. M., Chesworth, B. M., Speechley, M. R., Petrella, R. J., & Maly, M. R. (2013) · Physical Therapy · doi:10.2522/ptj.20130078 · Cited by 7 · see citing works
Darlow, B. J. S., Brown, M., Stanley, J., Abbott, J. H., Briggs, A. M., Clark, J., Frew, G., Grainger, R., Hood, F. E., Hudson, B., et al. (2023) · Musculoskeletal Care · doi:10.1002/msc.1785 · Cited by 6 · see citing works
Self-citationImpact of the Clinical Pharmacist in Rheumatology Practice: A Systematic Review
Barat, É., Soubieux, A., Brevet, P., Gerard, B., Vittecoq, O., Lequerré, T., Chenailler, C., Varin, R., & Lattard, C. (2024) · Healthcare · doi:10.3390/healthcare12151463 · Cited by 5 · see citing works
Simons, G., Ismail, N., Sandhu, K., Mallen, C. D., Stack, R. J., Pontefract, S. K., Raza, K., & Falahee, M. (2022) · BMC Rheumatology · doi:10.1186/s41927-022-00280-0 · Cited by 5 · see citing works
Marra, C. A., Tsuyuki, R. T., Soon, J. A., Gastonguay, L., Oteng, B., Cibere, J., McAuley, C., Esdaile, J. M., McGregor, M. J., & Khan, K. M. (2008) · Canadian Pharmacists Journal / Revue des Pharmaciens du Canada · doi:10.3821/1913-701x(2008)141[33:doarto]2.0.co;2 · Cited by 5 · see citing works
Self-citationUsing Population Health Constructs to Explore Impairment and Disability in Knee Osteoarthritis
Young, J., & Lemaire, E. D. (2017) · Springer eBooks · doi:10.1007/978-3-319-56949-9_9 · Cited by 5 · see citing works
Simkins, J., Holden, M. A., Babatunde, O. O., White, S. J., Nicholls, E. E., Long, A., Dziedzic, K., Chudyk, A., Todd, A., Walker, C., et al. (2024) · Musculoskeletal Care · doi:10.1002/msc.1873 · Cited by 4 · see citing works
Community pharmacist surveillance of hypertension in pregnancy
Tsao, N., Marra, C. A., Lynd, L. D., Thomas, J. M., & Ferreira, E. (2014) · Canadian Pharmacists Journal / Revue des Pharmaciens du Canada · doi:10.1177/1715163514543898 · Cited by 4 · see citing works
Self-citationEvolution of Clinical Pharmacy in the Practice of Rheumatology
Rowley, A. K., Resman‐Targoff, B. H., Marra, C. A., & Pucino, F. (2007) · Annals of Pharmacotherapy · doi:10.1345/aph.1k275 · Cited by 3 · see citing works
Self-citationLifetime physical activity and osteoarthritis
Ratzlaff, C. (2011) · cIRcle (University of British Columbia) · doi:10.14288/1.0072049 · Cited by 3 · see citing works
Leese, J. (2021) · cIRcle (University of British Columbia) · doi:10.14288/1.0401757 · Cited by 1 · see citing works
Is it time to screen for osteoarthritis?
Yoong, I. R. W., Mallen, C. D., & Smith, H. E. (2018) · Musculoskeletal Care · doi:10.1002/msc.1368
Young, J. J. (2018) · Scholarship@Western (Western University)
LI, L. C., Sayre, E. C., Xie, H., Falck, R. S., Best, J. R., Liu-Ambrose, T. Y. L., Grewal, N., Hoens, A. M., Noonan, G., & Feehan, L. M. (2018) · doi:10.2196/preprints.8514
(2008) · Current Opinion in Rheumatology · doi:10.1097/bor.0b013e3283110091
Dube, A. J., McCall, K. L., Stickney, K. E., & Gelinas, A. (2022) · medRxiv · doi:10.1101/2022.06.06.22276034
Results of unicompartmental osteoarthritis knee treated with high tibial osteotomy: a case series
Tahbildar, P., Shabeer, B. S., Sonowal, K., & Sarkar, I. R. (2023) · International Journal of Research in Orthopaedics · doi:10.18203/issn.2455-4510.intjresorthop20231187
- Authors
- Marra, C. A., Cibere, J., Tsuyuki, R. T., Soon, J. A., Esdaile, J. M., Gastonguay, L., Oteng, B., Embley, P., Colley, L., Enenajor, G., & Kok, R.
- Affiliations
- University of British Columbia (CA)
- University of Alberta (CA)
- Vancouver General Hospital (CA)
- Utrecht University (NL)
- ORCID
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2007-09-28
- Volume
- 57
- Issue
- 7
- Pages
- 1238-1244
- ISSN
- 0893-7524 (ISSN-L)
- 1529-0123
- OpenAlex
- W2060732058
- Cited by
- 48
- References
- 27
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 2 · 2018: 5 · 2017: 4 · 2016: 1 · 2015: 1 · 2014: 3 · 2013: 6 · 2012: 4
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Arthritis Society
- Health Canada
- Topics
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- knee osteoarthritis, pharmacist screening, community pharmacy, knee pain, screening questionnaire, radiographic osteoarthritis, body mass index, early osteoarthritis, American College of Rheumatology criteria
- MeSH terms
- Aged, British Columbia, Community Pharmacy Services, Female, Health Services Research, Health Status Indicators, Humans, Male, Middle Aged, Pharmacists, Surveys and Questionnaires, Osteoarthritis, Knee, Professional Role
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
